Brain Scans Might Spot Autism as Early as 6 Months of Age

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FRIDAY, Feb. 17, 2012 (HealthDay News) —
In children as young as 6 months old, changes in the brain that can lead to autism spectrum disorder may have
already begun, preliminary research suggests.

Although early signs of autism, such as problems communicating and
repetitive behaviors, can often be seen as early as 1 year, processes in the
brain linked to communication are seemingly being altered months earlier,
University of North Carolina researchers report.

"We know that there is evidence that autism affects the
ability of different brain regions to communicate with each other. This study
confirms that this atypical brain development begins very early in life,"
said study co-author Geri Dawson, the chief science officer at Autism Speaks.

"These findings raise the possibility of developing imaging
markers that could detect risk for autism in advance of actual symptoms, and
[to] begin treatment before symptoms begin," she said.

However, whether these brain changes occur in all autistic children
isn't known, Dawson said. It is possible that the developmental problems of
autism start even earlier, while in the womb, she said.

"One can imagine a day when you would use these imaging biomarkers
to identify a young
baby who is at risk and then provide them with early stimulation that could,
hopefully, reduce or even prevent the onset of autism," Dawson said.

The report was published in the Feb. 17 online edition of the American
Journal of Psychiatry.

For the study, a team led by Jason Wolff, a postdoctoral fellow at
the Carolina Institute for Developmental Disabilities at the University of
North Carolina, used MRI brain scans to look for early brain development in 92
infants.

The children underwent a special type of MRI called diffusion
tensor imaging at 6 months, 1 year and 2 years of age. These repeated scans
allowed the researchers to make three-dimensional pictures that show changes in
"white matter." White matter is a part of the brain particularly
embedded with nerve fibers that form information pathways between different
areas of the brain.

Of the 28 infants who developed autism spectrum disorder, the scans
showed different white matter development in 12 of the 15 brain pathways the
researchers looked at, compared with 64 infants who did not go on to develop
autism spectrum disorder.

At 6 months, these pathways were denser than usual in the babies
who developed autism spectrum disorder, but on later scans development had
slowed. At two years, the pathways were less dense than those of typical toddlers,
the researchers found.

These differences suggest that white
matter development is affected during early childhood, at the very
time the brain is making and strengthening these vital connections, the
investigators said.

"These brain changes appear to occur in advance of many
symptoms," said Wolff. "Autism unfolds over early development, and
this process may begin with basic differences in brain connections."

These early brain changes suggest the potential for biological
signs for early detection of autism, Wolff said. "This is an initial
study, but [it] holds promise for the development of early detection down the
road," he added.

In addition, there is the potential for intervention that could
disrupt the process that leads to autism, Wolff added. "We may be able to
intervene before autism fully manifests," he said.

This study is part of a larger, ongoing multi-site study, Wolff
said. "This is an initial sub-sample, and we are aiming to enroll about
400 infants
at high risk for autism and 150 at low risk. Eventually we will be
able to report on development of both brain and behavior in this group,"
he said.

Dr. Andrew Adesman, chief of developmental & behavioral
pediatrics at the Steven & Alexandra Cohen Children's Medical Center of New
York in New Hyde Park, said one drawback to this approach is the number and
cost of MRIs that would have to be done to identify babies at risk for autism.

"This is not a cheap or casual procedure," he said.

"However, this study suggests that there are roots to autism
on a neurological level very early on," Adesman said.

In the future, the new research may have a clinical application, he
said, but right now "this is not a diagnostic test and parents should not
be asking for it."

Another expert, Dr. Robert F. Lopez-Alberola, an associate
professor and chief of pediatric neurology at the University of Miami School of
Medicine, added that while it has been known that there are changes in the
brain in autism, "this is the first time we see this over time."

"From the clinical prescriptive, we may have identified a
potential marker for earlier diagnosing and then to begin interventions that
could make the symptoms less significant or even to prevent them," he
said.

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